MUAC IS THE BEST MEASURE FOR HIGH RISK ACUTELY MALNOURISHED CHILDREN English Jan 2016

1. 3a MUAC Is more specific for muscle mass (important for survival) compared to weight and height

2. MIND MAP FOR MID-UPPER ARM CIRCUMFERENCE (MUAC) IN ACUTELY MALNOURISHED YOUNG CHILDREN. From Andre Briend, Prepared by Alfred Zerfas Jan, 2016

3. 4. SHOULD MUAC AND WFH BE COMBINED AT THE SAME TIME TO IDENTIFY HIGH RISK CHILDREN? No.

3.1. No. Combining can decrease sensitivity and specificity for risk of dying. (Briend et al., 2012). Better to increase MUAC cut-point to increase sensitivity

4. CLICK ON ARROWS for article or video links and = signs for notes

5. 5. DO MUAC AND WFH (BELOW -3 Z-SCORE) IDENTIFY THE SAME CHILDREN? No.

5.1. Compared to WFH, MUAC selects preferentially young and stunted children who are more at risk

6. 6. IS IT NECESSARY TO USE MUAC FOR AGE OR HEIGHT INSTEAD OF MUAC ALONE? No.

6.1. Compared to MUAC for age or height, unadjusted MUAC preferentially selects younger children who are more at risk of mortality

7. 7. WHICH CRITERIA TO USE TO END TREATMENT BASED ON LOW MUAC ENTRY? - MUAC suggest 125mm

8. see also Briend 2012

9. 1. WHY?

10. 2. Best predictor for mortality compared to WTA, WTH and HFA (Pelletier J Nutr 1994)

10.1. 2.1 Conclusion

11. 2a Repeated measures (monthly) improves prediction for mortality (Briend et Zimicki, 1986

12. 3. Ease of Use - Can be done by CHW’s and mothers (pilot – ALIMA) N.Blackwell et al., 2015

13. See also Mothers and Children May 2015